I am not crazy about long term use of Xanax (or any other benzodiazepine) for treatment of chronic insomnia because they don’t produce all the normal sleep states (esp. stage 4 deep sleep). Whether this is the case in everyone and whether this effect persists indefinately has not been adequately studied. My main concern is that lack of stage 4 sleep can be associated with less secretion of growth hormone and other restorative processes that occur during the deepest sleep states – e.g., maintaining the immune system. There may also be some reduction of REM sleep – that might impair long term memory. None of this is adequately studied.

Xanax is a great medication for anxiety and can be used long term – but I prefer that it not be the primary medication for insomnia. Ambien CR, Lunesta, Sonata, or regular Ambien provide normal sleep. Tenex (Guanfacine) or Clonidine help induce deep sleep. Trazodone and Seroquel in low dose seem to provide relatively normal sleep although they are stronger meds and have other potential side effect issues.

Rozerem, a prescription med that stimulates specific Melatonin receptors associated with sleep problems (mainly with circadian rhythm problems) is also a possible solution.

Before considering any sleep meds, sleep habits (See Do’s and Don’ts of Sleep on my website) need to be addressed. One of the biggest causes of sleep problems is inadequate am bright light, and too much bright light at night (especially TV and computer screens).